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Condensing osteitis

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Q&A: What is “condensing osteitis”? Is it a form of osteomyelitis?

Author: Sanketh DS, MDS

Condensing osteitis, otherwise called chronic focal sclerosing osteomyelitis is a localised area of bone sclerosis occurring in the periapex of a tooth with an infected pulp. Usually products of infection act as irritants and cause bone lysis or resorption. But in cases of chronic long standing low grade infections of the tooth such as large carious lesions or secondary caries, toxins may get diluted and may act as a stimulus for bone proliferation rather than resorption. This sort of a reaction may occur in persons with high tissue resistance and reactivity, especially in children and young adults.

Condensing osteitis occurs most commonly in association with infected, non-vital mandibular molars and premolars. Since the infection is low-grade there is no associated pain or swelling.

Radiographs show a characteristic radiopaque mass surrounding the apex of the root. The entire root is usually visible with a widened periodontal ligament space. This is in contrast to cementoblastoma, which has a similar radiographic appearance except that the radiopaque mass surrounded by a radiolucent rim, is fused with the root and obscures the root outline.

Endodontic treatment or extraction of the infected tooth would result in a partial or total regression of the lesion in 85% of the cases. The radiopacity may persist in some cases even after treatment, and is referred to as a bone scar!

REFERENCES

Wood NK, Goaz PW. Differential diagnosis of oral and maxillofacial lesions.5th ed. Mosby;1997.

Neville BW, Damm DD, Allen CM, Chi A. Oral and Maxillofacial Pathology. South Asian ed. Elsevier; 2016.

Rajendran R, Sivapathasundaram B. Shafer’s Textbook of Oral Pathology. 8th ed. Elsevier; 2016.

Eversole R, Su L, ElMofty S. Benign fibro-osseous lesions of the craniofacial complex. A review. Head Neck Pathol. 2008;2(3):177-202.

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